Sebaceous carcinoma of the eyelids is rare and is usually seen in the elderly persons. The meibomian glands of the tarsus are the frequent sites of origin. The characteristic feature is a firm, painless nodule on the upper eyelid, We present a typical case of the sebaceous carcinoma in 60 year-old female. The patient had 1 * 1cm sized, hard, fixed, non-tender mass with bleeding on the right lateral canthus of 3~4 months duration. The histopathology of the lesion showed irregular sized lobules in the dermis with invasive growth to the surrounding stroma. Many fat containing sebaceous celles are seen in the center of the lobules.
Aged ; Ankle ; Dermis ; Eyelids ; Female ; Hemorrhage ; Humans ; Meibomian Glands ; Middle Aged

Median nerve injury after elbow dislocation is uncommon. The diagnosis of median nerve entrapment is often delayed. Median nerve paralysis is caused by entrapment within the elbow joint. If median nerve paralysis occurs following elbow dislocation or if it occurs following closed reduction, entrapment should be suspected. Optimal management of this problem consists of early surgical exploration and decompression. We report a case of a child who had entrapment of the median nerve in the elbow joint after closed reduction of posterior dislocation with fracture of the medial epicondyle. The diagnosis was made ten weeks after injury at surgical exploration. This case showed a characteristic radiologic sign in the anteroposterior radiograph. We released the entrapped median nerve with a successful result.
Child ; Decompression ; Diagnosis ; Dislocations ; Elbow Joint ; Elbow ; Humans ; Median Nerve ; Paralysis

PURPOSE: To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium. METHODS: Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations. RESULTS: The mean patient age was 57.9+/-10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05+/-5.78 weeks. The mean surgery time was 18.04+/-5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive. CONCLUSIONS: The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms . Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery.
Adult ; Aged ; Aged, 80 and over ; Conjunctiva/*transplantation ; Female ; Fibrin Tissue Adhesive/*therapeutic use ; Follow-Up Studies ; Humans ; *Limbus Corneae ; Male ; Middle Aged ; Postoperative Complications ; Pterygium/*surgery ; Tissue Adhesives/*therapeutic use ; Transplantation, Autologous

Fifteen cases of corrective operation for the ascending aortic aneurysm performed under general anesthesia from 1979 to 1985 in Severance Hospital were studied retrospectively. There were ten male patients and 5 female and their average age were 36.6 years(range 25~50 years). Most of the patients showed aortic regurgitation. Thus the anesthetic management involved consideration for patients with aortic dissection combined with aortic incompetence(annuloaortic ectasia). Patients were premedicated with atropine or glycopyrrolate in 14 cases and a combination of triflupromazine, hydroxyzine, diazepam and pethidine in 13 cases or a combination of hydroxyzine and morphine in 2 cases. Anesthesia was induced with thiopental sodium and/or diazepam and/or midazolam and/or morphine IV. Morphine and a mixture of 50% nitrous oxide and oxygen was administered for maintenance of anesthesia. Supplementary volatile anesthetics were inhaled as needed. Vasodilating therapy and avoidance of bradycardia during anesthesia are the most importance considerations for the reduction of left ventricular wall tension and to maximize the myocardial oxygen supply while maintaining cardiac output. Operative complications were reoperation due to bleeding in four cases, myocardial infarction in two cases, pericardial tamponade and urethral track infection in one case each. One patient died of sepsis. Fourteen patients improved in their heart size and function.
Anesthesia ; Anesthesia, General ; Anesthetics ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Atropine ; Bradycardia ; Cardiac Output ; Cardiac Tamponade ; Diazepam ; Female ; Glycopyrrolate ; Heart ; Hemorrhage ; Humans ; Hydroxyzine ; Male ; Meperidine ; Midazolam ; Morphine ; Myocardial Infarction ; Nitrous Oxide ; Oxygen ; Reoperation ; Retrospective Studies ; Sepsis ; Thiopental ; Triflupromazine

In a study of 460 cases of upper gastrointestinal bleeding admitted in Han Yang University Hospital during the 6 year period 1978-1983 inclusive, the following results were obtained. (continue...)
Hemorrhage*

This study was conducted to investigate the mothers' nutritional knowledge on weaning of 101 infants (8 for 4 mo, 44 for 5 mo, 45 for 6 mo, 4 for 7 mo) at a public health center of Incheon. Informations on the mothers' nutritional knowledge were obtained by questionnaires. In this survey 41.6% of infants were breast-feeding, 43.6% of them were bottle-feeding, and 14.9% of them were mixed feeding right after birth. The rate of breast-feeding right after birth was significantly higher in mothers of high school graduate than mothers of college/university graduate (p < 0.05). The infants of mothers graduated high school began to be weaned significantly earlier than the infants of mothers graduated college/university (p < 0.05). 95.1% of infants (n = 101) began to be weaned 4 to 6 months. 83.1% of infants were fed home-made weaning foods. 66.7% of infants were fed rice gruel, 18.5% of them were fruit juice, 6.2% of them were mixed grain, and 4.9% of them were commercially prepared weaning foods as their first supplementary foods. As main supplementary foods, 32.8% of infants were fed vegetable, 30.5% of them were rice gruel, and 27.7% of them were fruit juice. Mothers' nutritional knowledge related to weaning was significantly higher among mothers of college/university graduate than mothers of high school graduate (p < 0.05). 86.1% of mothers disagreed with the questionnaire in which breast-fed infants aged over 4 months needed to be fed iron sufficient food. For the improvement of nutritional status especially iron nutritional status of infants, nutritional education for mothers with weaning aged infants has to be increased and related programs have to be operated effectively.
Edible Grain ; Education ; Fruit ; Humans ; Incheon ; Infant* ; Iron ; Mothers ; Nutritional Status ; Parturition ; Public Health ; Vegetables ; Weaning*

BACKGROUND: Cytokeratins are epithelial markers whose expressions are not lost during malignant transformation. The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 110 patients with lung cancer. The aims of this study were to confirm sensitivity of Cyfra 21-1 in detecting non-small cell cancer, to assess the potential relationship between Cyfra 21-1 and disease stage of the lung cancer. METHODS: We measured serum levels of four tumor marker (NSE, CEA, SCC Ag, Cyfra 21-1) in 110 patients with lung cancer. The measurement of serum level of Cyfra 21-1 was performed with a cut off value of 3.3 ng/mL. An immunoradiometric assay was used to detect a fragment of the cytokeratin 19. The patients were grouped according to the stage of the disease and tumor type. RESULTS: Overall sensitivity of Cyfra 21-1 was relatively high (51.8%) than others tumor markers. Sensitivity of this marker was especially high for adenocarcinoma (63.2%) and squamous cell carcinoma (54.1%). In contrast, sensitiviy of Cyfra 21-1 was relatively low for small cell lung carcinoma (40.0%). Serum levels of Cyfra 21-1 were higher in advanced nonsmall cell lung cancer than early stage disease. CONCLUSION: We conclude that Cyfra 21-1 is a sensitive tumor marker of nonsmall cell lung cancer, especially adenocarcinoma and also may be a useful adjunctive marker for disease monitoring.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunoradiometric Assay ; Keratin-19 ; Keratins ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma ; Biomarkers, Tumor

BACKGROUND: To evaluate the efficacy and safety of gemcitabine and cisplatin chemotherapy in advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Forty patients (21 men, 19 women ; age range, 37 to 73 years; median, 63 years) with unresectable stage IIIB to IV NSCLC were evaluated. Patients received cisplatin 60mg/m2 (Day 1), gemcitabine 1200mg/m2 (Day 1 and 8) every 21 days. Eighteen patients had stage IIIB disease and 22 had stage IV. There were 28 patients of adenocarcinoma (70.0%), 11 of squamous cell carcinoma (27.5%), and one of large cell carcinoma (2.5%). RESULTS: Of 40 patients, no patients showed complete response while 15(37.5%) showed partial response, 7(17.5%) had stable diseases, 18(45%) had progressive diseases. During a total of 195 courses of chemotherapy, grade 3 or more granulocytopenia and thrombocytopenia occured in 12.5% and 2.5% of patients respectively. Non-hematologic toxicity was mild and easily controlled. There was one case of treatment-related death by pneumomia. The median survival was 55 weeks (95% CI, 34~75weeks), and the time to progression was 19 weeks (95% CI, 16~23weeks). One year survival rate was 55% and 2 year survival rate was 10%. CONCLUSION: The efficacy of cisplatin and gemcitabine combination chemotherapy was acceptable in the treatment of advanced NSCLC.
Adenocarcinoma ; Agranulocytosis ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Male ; Survival Rate ; Thrombocytopenia

The diagnosis of drowning is one of the most difficult in forensic pathology. One of the most common autopsy findings in drowning cases is a heavy, edematous lung as the result of water that is aspirated into the lungs before death. There are several controversial findings and arguments about the lung weight as a marker of drowning. The aim of the present study is to examine the difference in the lungs to the spleen weight ratio between seawater and freshwater drowning, compared with asphyxiation and acute cardiac death. This study compared the weight ratio of the lungs to the spleen for 29 cases of drowning (24 males, 5 females), 30 cases of mechanical asphyxiation (16 males, 14 females), and 37 cases of acute cardiac death (30 males, 7 females). This study presented significant differences in the lungs to the spleen weight ratio between drowning and the other causes of death . Therefore, these findings suggest that the ratio may be a useful index for accurate diagnosis of death by drowning.
Autopsy ; Cause of Death ; Death ; Diagnosis ; Drowning* ; Forensic Pathology ; Fresh Water ; Humans ; Lung* ; Male ; Seawater ; Spleen* ; Water

PURPOSE:To evaluate the changes of QT dispersion (QTd) in CAPD patients serially from the period before the initiation of CAPD until several years after CAPD, and to find any associated factors. METHODS:We performed a retrospective cohort study with a total of 101 patients who initiated CAPD between 1990 and 1996. All data were recruited from the patients' medical records before CAPD initiation, within one year after CAPD, and between one and three years after CAPD. RESULTS:QTd and Corrected QTd (QTdc) values after CAPD did not show differences in the paired t-test of those before CAPD and within one year after CAPD. There was a definite correlation between the QTds before CAPD and that within one year after CAPD (r=0.530, p<0.001). In addition, the QTds from within one year after CAPD showed a correlation with those taken from one to three years after CAPD (r=0.487, p=0.019). Upon analysis of all-cause mortality, the change rate of QTd after CAPD initiation was revealed as a predicting factor along with the QTd, QTc max, and QTdc within one year after CAPD (RR=1.055, p=0.005). The change rate also remained a predictor of cardiovascular mortality (RR= 1.088, p=0.007). In a multivariate Cox regression, cardiomegaly and previous cardiovascular disease were revealed to be independent factors for the change rate of QTd. CONCLUSION:QTd in CAPD patients did not change after initiation of CAPD, and the change rate of QTd after CAPD initiation was revealed as a risk factor for both all-cause mortality and cardiovascular mortality.
Cardiomegaly ; Cardiovascular Diseases ; Cohort Studies ; Humans ; Medical Records ; Mortality ; Peritoneal Dialysis, Continuous Ambulatory* ; Retrospective Studies ; Risk Factors